Keihani-Douste Zarrin, Daneshjou Khadijeh, Ghasemi Mehdi
Department of Pediatrics, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran.
Med Sci Monit. 2006 Dec;12(12):CS119-122. Epub 2006 Nov 23.
This report presents a child with spinal cord lesion with concomitant multiple brain abscesses caused by brucellosis.
A 12-year-old boy was admitted with quadriplegia accompanied by back pain, headache, nausea, and incontinence which appeared six months before. MRI revealed multiple brain abscesses as well as spinal intramedullary lesions. The diagnosis of brucellosis was established by positive serum Wright test (1:2560) and 2-mercaptoethanol agglutination titer (1:2560), history of exposure, and gradual improvement in response to treatment (rifampin, trimethoprim/sulfamethoxazole, gentamicin, and prednisolone).
Neurobrucellosis may present with uncommon manifestations in children. Physicians should consider this in the differential diagnosis of a child with quadriplegia.
本报告介绍了一名患有脊髓病变并伴有布鲁氏菌病引起的多发性脑脓肿的儿童。
一名12岁男孩因四肢瘫痪入院，伴有六个月前出现的背痛、头痛、恶心和失禁。磁共振成像显示有多发性脑脓肿以及脊髓髓内病变。通过血清wright试验阳性（1:2560）、2-巯基乙醇凝集滴度（1:2560）、接触史以及对治疗（利福平、甲氧苄啶/磺胺甲恶唑、庆大霉素和泼尼松龙）的反应逐渐改善，确诊为布鲁氏菌病。
神经型布鲁氏菌病在儿童中可能表现为不常见的症状。医生在对四肢瘫痪儿童进行鉴别诊断时应考虑到这一点。
